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Trans-lesional fractional flow reserve gradient as derived from coronary CT improves patient management: ADVANCE registry.
Trans-lesional fractional flow reserve gradient as derived from coronary CT improves patient management: ADVANCE registry. Journal of cardiovascular computed tomography Takagi, H., Leipsic, J. A., McNamara, N., Martin, I., Fairbairn, T. A., Akasaka, T., Norgaard, B. L., Berman, D. S., Chinnaiyan, K., Hurwitz-Koweek, L. M., Pontone, G., Kawasaki, T., Ronnow Sand, N. P., Jensen, J. M., Amano, T., Poon, M., Ovrehus, K. A., Sonck, J., Rabbat, M. G., Mullen, S., De Bruyne, B., Rogers, C., Matsuo, H., Bax, J. J., Douglas, P. S., Patel, M. R., Nieman, K., Ihdayhid, A. R. 2021Abstract
BACKGROUND: The role of change in fractional flow reserve derived from CT (FFRCT) across coronary stenoses (DeltaFFRCT) in guiding downstream testing in patients with stable coronary artery disease (CAD) is unknown.OBJECTIVES: To investigate the incremental value of DeltaFFRCT in predicting early revascularization and improving efficiency of catheter laboratory utilization.MATERIALS: Patients with CAD on coronary CT angiography (CCTA) were enrolled in an international multicenter registry. Stenosis severity was assessed as per CAD-Reporting and Data System (CAD-RADS), and lesion-specific FFRCT was measured 2?cm distal to stenosis. DeltaFFRCT was manually measured as the difference of FFRCT across visible stenosis.RESULTS: Of 4730 patients (66?±?10 years; 34% female), 42.7% underwent ICA and 24.7% underwent early revascularization. DeltaFFRCT remained an independent predictor for early revascularization (odds ratio per 0.05 increase [95% confidence interval], 1.31 [1.26-1.35]; p?0.13, would potentially reduce ICA by 32.2% (1638-1110, p?
View details for DOI 10.1016/j.jcct.2021.08.003
View details for PubMedID 34518113